15D2147588 CLIA NUMBER - MIDWEST EYE CONSULTANTS #34

Laboratory Demographics

  • CLIA Code: 15D2147588
  • Facility Name: MIDWEST EYE CONSULTANTS #34
  • Facility Address: 301 J STREET
    LA PORTE, IN
    ZIP 46350
  • Facility Phone: 219 362-8923
  • Facility Type: Physician Office
  • Facility Type: Waiver
  • Lab Director: KYLE J. ANTOS
  • NPI Number: 1265480933
  • Taxonomy: 152W00000X - Optometrist

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CLIA Record

Field Name Field Value
CLIA Number 15D2147588
LAB Type Physician Office
Facility Name MIDWEST EYE CONSULTANTS #34
Street 301 J STREET
City LA PORTE
State IN
ZIP 46350
Phone 219 362-8923
Certificate Type Certificate of Waiver
Certificate Type Description This certificate is issued to a laboratory to perform only waived tests.
Certificate Effective Date 4/23/2024
Certificate Expiration Date 4/22/2026
Facility Type Physician Office
Lab Director KYLE J. ANTOS

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This page was last updated on: 9/29/2025